Ensemble Health Partners is a hospital and healthcare company that partners with client hospitals to help them develop processes, train teams, reach their finan
Accounts Receivable Associate Specialist
Location
Tennessee
Posted
7 days ago
Salary
$17 - $18 / hour
Seniority
Mid Level
Job Description
Accounts Receivable Associate Specialist
Ensemble Health Partners
• Following up directly with commercial, governmental, and other payers to resolve claim payment issues. • Securing appropriate and timely reimbursement and response. • Identifying and analyzing denials, payment variances, and no response claims and acts to resolve claims/accounts. • Drafting and submitting technical and clinical appeals. • Providing support for all denial, no response, and audit activities. • Examining denied and other non-paid claims to determine the reason for discrepancies. • Communicating directly with payers to follow up on outstanding claims. • Files technical and clinical appeals, resolves payment variances, and ensures timely and accurate reimbursement. • Works with management to identify, trend, and address root causes of issues in the A/R. • Maintaining a thorough understanding of federal and state regulations, as well as payer specific requirements and takes appropriate action accordingly. • Documenting all activity accurately including contact names, addresses, phone numbers, and other pertinent information in the client’s host system and/or appropriate tracking system. • Demonstrating initiative and resourcefulness by making recommendations and communicating trends and issues to management.
Job Requirements
- Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel.
- Excellent Verbal skills.
- Problem solving skills, the ability to look at accounts and determine a plan of action for collection.
- Critical thinking skills, the ability to comprehend tools provided for securing payment, and apply them to differing accounts to result in payment.
- Adaptability to changing procedures and growing environment.
- Meet quality and productivity standards within timelines set forth in policies.
- Meet required attendance policies.
- Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.
- 2 or 4-year college degree preferred.
- 1 or more years of relevant experience in medical collections, physician/hospital operations, AR Follow-up, denials & appeals, compliance, provider relations or professional billing preferred.
- Knowledge of claims review and analysis.
- Working knowledge of revenue cycle.
- Experience working the DDE Medicare system and using payer websites to investigate claim statuses.
- Working knowledge of medical terminology and/or insurance claim terminology.
Benefits
- Remote Role
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
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